Somatic and psychological features of headache in systemic lupus erythematosus

Objective. Headaches - especially of migrainous type - have been considered part of the disease spectrum of systemic lupus erythematosus (SLE). We wis hed to characterize prevalence and types of headaches in SLE and find out i f headache is associated with disease. personality traits, or other psychol ogical factors. Methods. Fifty-eight consecutive Caucasian patients with SLE were given a c linical examination. We recorded SLE disease activity according to the SLE Disease Activity Index, types of headache according to International Headac he Society criteria, and personality traits and emotional status according to Minnesota Multiphasic Personality Inventory-2 and Beck Depression Invent ory (BDI). Results, Thirty-eight SLE patients (66%) were headache sufferers: of these. 22 patients (38%) had migraine and 21 (36%) had tension-type headache. Hea daches were not associated with disease activity or any other disease assoc iated variable. including tests for antiphospholipid antibodies. Migraine w as associated only with a tendency to social isolation and anxiety, while t ension-type headache was associated with psychological distress, such as an xiety, somatic complaints, reduced energy, mental tension, social discomfor t and withdrawal, and depressive mood according to the BDI, Conclusion. Migraine and tension-type headaches occur frequently in patient s with SLE. Migraine shows the same clinical presentation as in a non-SLE p opulation, and may not be part of a neuropsychiatric disease spectrum. This also applies to tension-type headache, which in contrast to migraine shows some associations with emotional and personality traits. and could represe nt components of a chronic pain syndrome.